The Hawaii Medical Marijuana Act (Senate Bill 862) passed in 2000. It permits patients to possess up to 3 ounces of usable marijuana, as well as 7 plants (3 mature, 4 immature).

Patients are required to obtain a letter from their physician, stating that they have a debilitating medical condition, which consumption of medical marijuana could potentially benefit. Approved conditions include HIV/AIDS, cancer, glaucoma, severe paid or nausea, and seizures. The Hawaii Department of Health is charged with approving medical marijuana use to treat other conditions.

Hawaii’s medical marijuana law removes state-level criminal penalties for the use, possession and cultivation of marijuana. However, users can quickly find themselves on the wrong side of state or federal law, regardless of their patient status. Patient registry in a confidential state-run database is required.

As of 2010, more than 8,000 patients had registered. However, Hawaii is among a growing number of states that has made medical marijuana legal, but has no legal means of providing for its sale. Thus, patients are left to cultivate their own or turn to the black market. Participating physicians must work with the Narcotics Enforcement Division, which oversees the medical marijuana program. Medical marijuana in Hawaii is governed by the Department of Public Safety – the state’s law enforcement arm. In most states, oversight of medical marijuana is done by the Department of Health.

While lack of dispensaries has permitted Hawaii to avoid many of the pitfalls and legal complications experienced in California, it comes at a cost of patient access. Advocates for access continue to argue that law-abiding citizens should not have to resort to illegal means to obtain legal medication.

In early 2013, the Hawaii House took up several bills to change the state’s medical marijuana law, including redefining adequate supply as 5 ounces, certifying physician requirements, addressing caregiver to patient ratio, and transportation and registration requirements. A separate measure would transfer oversight from the Department of Public Safety to the Department of Health.

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